PLAB 2 GMC Good Medical Practice & Professional Standards 2 — Questions and Answers
Question 1: A doctor is asked to complete a sick note for a patient they have not examined. The patient states they are too unwell to attend the surgery. What is the most appropriate action?
- Offer a telephone or video consultation to assess the patient before completing any documentation (Correct answer)
- Decline to issue a sick note unless the patient attends in person
- Issue the sick note on the basis of the patient's account to avoid unnecessary delays
- Ask a colleague to countersign the sick note to share responsibility
Correct answer: Offer a telephone or video consultation to assess the patient before completing any documentation
GMC Good Medical Practice requires that clinical documentation must be based on an assessment of the patient; a remote consultation satisfies this requirement when an in-person visit is not possible.
Question 2: Under GMC guidance, when is a doctor permitted to breach patient confidentiality without consent?
- When disclosure is required by law, necessary to prevent serious harm to the patient or others, or in the public interest as defined by law (Correct answer)
- Whenever a senior colleague or manager instructs them to disclose information
- When the patient is unable to consent and a family member requests disclosure
- Only when the patient has died and the information is needed for research purposes
Correct answer: When disclosure is required by law, necessary to prevent serious harm to the patient or others, or in the public interest as defined by law
GMC guidance permits breach of confidentiality without consent in specific circumstances: legal obligation, serious risk of harm to the patient or third parties, or a clear public interest justification.
Question 3: A doctor becomes aware that they are experiencing significant stress and burnout that is affecting their ability to concentrate during clinical duties. What should they do first?
- Seek support from their own GP or occupational health and consider whether their fitness to practise is affected (Correct answer)
- Continue working and manage the stress privately to avoid professional repercussions
- Inform the GMC immediately before taking any other action
- Ask a trusted colleague to supervise all their clinical decisions until they feel better
Correct answer: Seek support from their own GP or occupational health and consider whether their fitness to practise is affected
GMC guidance requires doctors to look after their own health and wellbeing and to seek help when needed, and to consider whether their health is affecting their ability to practise safely.
Question 4: What is the GMC's position on a doctor expressing personal beliefs to patients?
- Doctors may hold personal beliefs but must not impose them on patients or let them affect the care they provide (Correct answer)
- Doctors are free to recommend treatments aligned with their personal beliefs provided they explain their reasoning
- Doctors must not disclose any personal beliefs to patients under any circumstances
- Doctors may decline any treatment they personally disagree with and are not required to arrange alternative care
Correct answer: Doctors may hold personal beliefs but must not impose them on patients or let them affect the care they provide
GMC guidance states that while doctors may hold personal beliefs, these must not prejudice patient care, and when conscientious objection applies, doctors must refer patients to alternative providers.
Question 5: A doctor is asked to provide a reference for a former colleague who was subject to a conduct investigation that was ultimately not proven. What should the reference include?
- The reference should be factually accurate, honest and not misleading, including relevant information about the investigation if directly relevant to the role (Correct answer)
- The reference should omit the investigation entirely as it was not proven
- The doctor should decline to write the reference to avoid potential legal consequences
- The doctor should include only positive aspects of the colleague's performance to maintain professional loyalty
Correct answer: The reference should be factually accurate, honest and not misleading, including relevant information about the investigation if directly relevant to the role
GMC guidance requires references to be honest, accurate and not misleading; omitting relevant factual information that could affect patient safety is a breach of professional standards.
Question 6: According to GMC equality and diversity guidance, how should a doctor approach a patient who holds views or a lifestyle very different from their own?
- Treat the patient with the same respect and standard of care as any other patient, setting aside personal views (Correct answer)
- Decline to treat the patient and refer them to a colleague who shares their values
- Treat the patient but document any personal reservations in the clinical notes
- Provide care but suggest the patient seek a more culturally aligned healthcare provider in future
Correct answer: Treat the patient with the same respect and standard of care as any other patient, setting aside personal views
GMC Good Medical Practice requires doctors to treat every patient with dignity and respect, without discrimination based on lifestyle, beliefs, or personal characteristics.
Question 7: A doctor is concerned that a patient may have been the victim of domestic abuse but the patient denies it and does not wish to discuss it. What is the most appropriate course of action?
- Respect the patient's wishes, document concerns sensitively in the notes, offer appropriate resources, and ensure the patient knows they can return (Correct answer)
- Immediately notify the police as a safeguarding concern overrides patient confidentiality in all domestic abuse cases
- Do nothing further as the patient has denied abuse and their autonomy must be fully respected
- Refuse to end the consultation until the patient acknowledges the concern
Correct answer: Respect the patient's wishes, document concerns sensitively in the notes, offer appropriate resources, and ensure the patient knows they can return
When a patient denies abuse but the doctor has concerns, best practice is to sensitively document findings, provide information about support services, and leave an open door for future disclosure while respecting patient autonomy.
PLAB 2 GMC Good Medical Practice & Professional Standards 2
A doctor is asked to complete a sick note for a patient they have not examined.
The patient states they are too unwell to attend the surgery.
What is the most appropriate action?